Eligibility Updates

Please carefully read the IHCP bulletin that clarifies presumptive eligibility for incarcerated individuals. The information in the bulletin is different from what we understood from previous written directives and training material from FSSA. Note: This bulletin provides descriptions and examples of incarceration vs. non-incarceration which could result in an inmate PE vs. a regular PE. […]

IHCP recently announced that beginning April 1, 2017, MDwise will no longer be a managed care health plan option for Hoosier Care Connect members. Hoosier Care Connect members currently enrolled with MDwise have already started receiving notices from the Office of Medicaid Policy and Planning informing them of this change. Read the full IHCP bulletin […]

FSSA has a contact page on their website where you can submit inquiries or information related to a case. Some items you may inquire about are: Status of an application HIP POWER account payment confirmation Correcting HIP effective dates Reporting changes Some Advocates have had success in resolving issues with application by submitted inquiries though […]

In response to popular demand, we’ve now added a HIP Jail Suspended Reason to the HIP Approval T-Code that should be used for ALL cases where an applicant receives the “…your HIP Application has been suspended because…” letter. Please have ALL of these accounts currently in PENDED status updated with this so that they will […]

After discussions with DFR leadership, it has been decided that ClaimAid Advocates should use an Authorized Representative (AR) form without a barcode, unless you have printed it from the submitted application and is thus linked to that specific case. The generic AR form (with barcode) that we had been using was found to be scanning […]

FSSA state form 55367 explains the rights and responsibilities of an individual applying for an Indiana Health Coverage Program (IHCP). It is very important that you explain this document to the individuals we assist and give them a copy for their records. The document prints when you choose the option to “Print Application” after you […]

All income and resource changes that are effective in 2017 should be reflected by March 1 following the Federal adjustment of the Federal Poverty Level. The following are changes that are effective 1/1/2017: 3005.25.00 RESOURCE LIMITS (MED 4) The resource limits for the QMB, SLMB, QDW, and QI categories are: $7,390 effective 1/01/17 for an […]

The presumptive eligibility (PE) processes will continue to operate with CoreMMIS. Advocates and Qualified providers (QPs), will use the new Portal to submit PE applications beginning February 13, 2017. Functionality for processing PE applications will remain available throughout the transition to CoreMMIS and the Portal. The transition of processing PE applications from Web interChange to the Portal will […]

In the course of working with many of our disabled and aged patients, we will run into patients that qualify for Medicare coverage that have not enrolled in that coverage. Many of them believe that they are not eligible for Medicare or cannot afford the part B premium and have dis-enrolled from that coverage. We […]

FSSA announced earlier this year that they would be adding a fourth Managed Care Entity (MCE) as an option for HHW and HIP members. Upon successful completion of the readiness evaluation, the MCE options will be Anthem, CareSource, MDwise, and MHS. Since CareSource is a new MCE, you will need to confirm with your facilities whether or […]

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ClaimAid is a leading provider of full-service eligibility and claims resolution for hospitals, patients and their families. As the health marketplace continues to evolve and new coverage options emerge, ClaimAid will continue to guide our clients through the process, helping them understand the options available and what the changes mean for them.